Demonstrate the use of official coding references; and presenting
explanations of concepts or methods. Explain why this resource would be
beneficial to a coder. (read the article below)
QUESTION 4
What would the correct code assignment be
for the dilation of a sleeve gastrectomy? Some of our coders have
assigned CPT code 43245 however; the other coders feel that this code is
reported for dilation of a gastric outlet so it doesn’t seem to be the
correct code to use.
Would CPT code 43999 be the best code to
describe the dilation of a gastric sleeve procedure via an
esophagogastroduodenoscopy (EGD) approach?
ANSWER
Based on the operative note, the scope was
passed into the gastric sleeve … and an area was noted to be stenotic
… . The stenosis was dilated without difficulty. Therefore, report CPT
code 43245, Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (e.g., balloon, bougie),
for the gastric sleeve dilation procedure performed. Please note, CPT
code 43245 is not limited to the dilation of gastric outlet. Dilation of a sleeve gastrectomy
Coding Clinic for HCPCS – Second Quarter 2014 Page: 3
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